BY GUEST BLOGGER | APRIL 8, 2013
Ever heard anyone say it was a great time in their life to get cancer? No! You'll usually hear people talk about their diagnosis in reference to some other major life event. Either "My daughter was getting married," or "I had just started a new job when I found my lump."
The first time I was diagnosed with breast cancer, it was a few months after I married the love of my life. We married on Valentine's Day, 2009, and honeymooned in March. I turned 29 in April, and I was diagnosed in May. After a bilateral mastectomy and 18 weeks of chemotherapy, the year was coming to a close. After a particularly rough day, I looked at my husband and joked, "Well, 2009 kind of sucked. 2010 has GOT to be better!"
Chris responded very matter-of-factly, "I for one refuse to think of 2009 as bad - it's the year we got married." He was right then, and now he is even more right.
How many years can be defined as cancer years? 2012 can't be known as the year of my recurrence. It's the year we adopted Henry.
I refuse to let cancer define my life or the way I think about it.
When you have metastatic disease, you have to shift your way of thinking. I will always be in some form of treatment. We are not marching toward the light at the end of the tunnel like I did with the first go 'round. This is not a temporary situation or something I am going through. It's not the path I would have picked, but it is the hand that I have been dealt. And so, THIS IS MY LIFE. I can't think of it in terms of weeks between scans or times in or out of the chemo chair.
Right now, I'm not sure if I am responding or progressing on my new medication (anastrazole) since my last scan had mixed results. But I have a little guy who is learning how to walk, and we just bought and moved into a new house. Cancer is just going to have to take a backseat. I'm too busy to stress about it today. I need to buy a new shower curtain and pick out paint colors for Henry's room ... I'll worry about cancer in a few weeks when I check into the PET scan waiting room.
Carrie Corey is a wife, mom and metastatic breast cancer survivor. She will be reporting in frequently on her journey.
BY GUEST BLOGGER | APRIL 3, 2013
"What is this lump on his neck?" asked our family physician. Just past six and a half months old, our baby, Jasan, had a few nights of intense crying followed by nausea and diarrhea. That prompted a visit to the family doctor, Richard L. Huffer. He was an amazingly thorough doctor and as he was examining Jasan, he kept going back to Jasan's left neck over and over again. He found a lima bean-sized lump on Jasan's left neck. I told him that I had given him a bath just before leaving home and didn't notice anything out of the ordinary. He guided my right index finger over the left neck and sure enough there was a lump. He told me it might be a gland that was infected and that a course of ampicillin would probably do the trick.
The next week was somewhat normal for an almost seven-month-old baby; he ate, played, got changed, slept and fought me every inch of the way when it came to taking the ampicillin! The lump didn't really shrink; in fact I thought it was getting bigger, so we were back in the doctor's office before our next appointment. Dr. Huffer had spoken to a surgeon at Loma Linda University Medical Center and knew that it was time to refer us to him. I asked him if it was serious, "like cancer serious?" He handed Jasan to the receptionist and did his very best to calm me. He told me to let the Loma Linda guys check him out; told me to call him as soon as I knew a diagnosis, gave me a hug and sent us home. I packed a couple of small bags for the two of us and then with Jasan on the floor grabbing at the dog's tail, I just sat on our bed and bawled. I just felt so helpless.
I made the necessary phone calls to family and friends and then enlisted the help of my sister-in-law, Mary, to make the trip with us the next morning. She was great at tending to her little nephew as we drove and kept my mind off the challenge of the day. My husband, Jim, would join us the next afternoon.
After the initial examination by the pediatrician, we waited to see the pediatric surgery team. By this time Jasan had a mass the size of a small egg on his left neck and was extremely agitated. Jim joined us late in the afternoon with the news that he was staying with us for a few days until we knew a little more about what we were facing.
Jasan was admitted to the hospital that evening and surgery to excise the lump was scheduled for the next morning. Paperwork had to be signed that evening and we wanted to hear any news from the surgical team when they made rounds. They told us the surgery would be about four hours. It was closer to six. They also told us that when he came out of surgery he would be hooked up to tubes, monitors, lots of bandaging on the neck and most likely would still be groggy from the anesthesia. After surgery, his crib was pushed out of the surgical elevator, he saw his daddy and all we heard was a very loud "dada dada dada" and saw no tubes, no monitors and only a small bandage on his neck. We were elated.
A frozen section during the surgery gave us a preliminary diagnosis of neuroblastoma, a sympathetic nerve cell cancer. The formal diagnosis came about a 10 days after surgery when reports were returned from various labs across the country.
Neuroblastoma. Tumor. Malignant. Radiation. The fight was just beginning!
The following days were filled with more blood tests , 24-hour urine collections, tomograms, esophagogram, radiology studies, bone marrow test (this was the worst so far...no anesthesia ... just blood-curdling screams from Jasan as we waited for him just outside the procedure room). The oncology and medical teams wanted to discuss treatment with Jim and me. We listened to the information they presented. Our decision would ultimately determine our baby's future health. We both felt so helpless. What should we do?
After two weeks we were released to go home. We had to return three days later to see the radiation therapy team. At that appointment Jasan was fitted with a clear Plexiglas mask that could be strapped to the table in the radiation chamber so that he couldn't move his head during the treatments. This was worse than hearing those blood-curdling screams during the bone marrow test.
Jasan cried and screamed and yelled "mama," "dada," and "no, no, no" through a series of 25 radiation treatments. Subsequently, he fought thyroid cancer at age 15 and at age 21 had a recurrence of thyroid cancer. Three cancers would seem more than enough for one child, yet in between were numerous scares, hospitalizations, more surgeries, illnesses, regular testing; all due to the side effects of radiation.
Did we make the best decision? We think that we did. The oncology team told us we could do nothing and take our chances of Jasan living a few more months or we could choose radiation and that would give him at least 18 more months on this earth and possibly side effects through the years.
Jasan has surpassed those 18 months by three decades plus and now serves as a cancer advocate helping others meet their own challenges. We know it hasn't been easy for him or for us, but we were always by his side and that will never change.
Note: Jasan's neuroblastoma was diagnosed in 1976. We lived in a small town of about 25,000 people. There were no support groups, no major medical centers and we didn't know anyone that had a child with cancer. We traveled an hour and 15 minutes each way from Indio, Calif. to Loma Linda University Medical Center in Loma Linda, Calif. for each appointment, treatment and hospitalization. Jasan's case was the 26th neuroblastoma in the U.S. It was the first tumor recorded on the neck, most are found in the stomach. Thank you, Dr. Huffer and LLUMC for saving Jasan's life!
Carolyn Zimmerman is the mom/caregiver of a three-time cancer survivor. Her experience covers caring for a six-month-old baby diagnosed with neuroblastoma, a 15 year old diagnosed with mixed papillary and follicular thyroid cancer, and a 21 year old diagnosed with recurrence of the thyroid cancer. She says the treatments, surgeries, scares, support and dealing with the medical world have been a major part of her son's life and directly affected her role as mom/caregiver.RELATED POSTS
BY KATHY LATOUR | FEBRUARY 28, 2013
I loved it when breast surgeon and breast cancer advocate Susan Love said she would rather talk about death than sex. I think it puts in perspective how very difficult it is to discuss something that has always been seen as mystical, and yet, as we all know, people who can talk about it have the best sex lives.
I say "people" because single people get cancer too. So, whether single or married or divorced or whatever, cancer changes our perspective on sex. When I wrote my book "The Breast Cancer Companion," I wanted to include sex because it had been an issue in my marriage and I knew it would be for other women.
What surprised me was the wide variation of responses that women and men gave me when I asked about sex. One woman said she and her husband had become so close during the cancer experience that she was having trouble relating to him sexually, and another said she refused to talk about sex because they never had. It had been the one thing in their marriage that worked without words or communication of any kind and now the deal had changed and she was angry.
For men who get cancer the issues can be the same or different. Some men see it as their place to take charge in the bedroom, and if they feel diminished physically because they don't feel well or they have had to let their wives take care of them, they may have trouble finding their role again.
The bottom line is that cancer changes us, mentally, physically, emotionally, spiritually and if you look at that list, each of those facets is part of sex. It also changes our partners who will, perhaps, see us differently than they ever have. How these changes play out in sex will depend on the two people who have gone through the experience and their commitment to the relationship and each other.
For single people it's a whole different ball game as they try to find a life partner with the added chapters of their life that cancer brings. Fertility may be affected by cancer, and there is always the question, "So when do I tell him or her that I have had cancer."
Talk to people who have been there, get help to find your way, every piece of advice comes from a core message: communicate. Communicate with your partner, your potential partners, yourself.
We have done a number of stories about sex in CURE. Go to www.curetoday.com and put sex in the search field and have fun.RELATED POSTS
BY DEBU TRIPATHY | FEBRUARY 18, 2013
Personalized cancer medicine has become a major buzzword as of late, but what does it really mean?
Everyone defines it differently, so the bird's eye view of this term would be as encompassing as possible. On one level, it means that every patient is an individual and that their course through the diagnosis and treatment of cancer should reflect their values and preferences within the boundaries of medical evidence that is works. The way information is communicated, the way different choices are presented, and even how treatment choices are balanced against side effects (sometimes permanent), all need to be customized.
A mother of two young children and a professional violinist might make very different treatment decisions about using a chemotherapy agent that causes neuropathy even if the benefit (improvement in cure rate) is identical. Similarly, the medical care team needs to formulate tailored strategies to keep patients satisfied with treatment, compliant with medications and educated about when to call with side effects. Using a one-size-fits-all approach will probably lead to much lower performance in all these departments.
A very different definition of personalized medicine is the high tech world of genomics and proteomics that exposes unique vulnerabilities in an individual's cancer. Just in the last year, massive amounts of genomic information from the tumors of many patients has been made available through publications and databases-–analyzing this fire hose of data is starting to reveal that cancers do in fact harbor many genetic "drivers," and the next step will be to squelch these with targeted drugs. Also, deciphering inherited variations the drug metabolizing enzymes will help us predict who is more susceptible to drug side effects--further customizing treatments.
The best model of personalized medicine is one that integrates all these definitions to create an environment that revolves around the patient. This includes a rationally composed and individualized treatment plan using the best science along with supportive approaches that add up to a holistic plan that is reflective of the individual. Let's hope that health care reform will encourage and incentivize personalized medicine for cancer.RELATED POSTS
BY ELIZABETH WHITTINGTON | FEBRUARY 6, 2013
Pancreatic cancer is an aggressive, hard-to-treat disease, especially once it spreads outside the pancreas. Unfortunately, about 80 percent of pancreatic tumors are diagnosed at stage 4. Because of the nature of the disease, even small gains are cause to take notice.
At the 2013 Gastrointestinal Cancers Symposium, results of the MPACT study, a phase 3 international trial that examined Abraxane and gemcitabine extended overall survival by more than 7 weeks when compared with gemcitabine alone.
Abraxane, called nab-paclitaxel, is a form of Taxol which is encased in a protein and is given intravenously. This formulation helps reduce side effects, such as severe allergic reaction, and the protein albumin may make it easier for the active compound paclitaxel to reach cancer cells than the camphor oil used in traditional Taxol.
Daniel Von Hoff, lead investigator of the MPACT study, presented the results at the conference as a late-breaking abstract. The study included 842 patients with newly diagnosed metastatic pancreatic cancer. Researchers found that the combination increased the median overall survival by almost two months (8.5 months compared with 6.7 months), meaning that half of the patients in the Abraxane arm were alive at 8.5 months.
Von Hoff noted that the benefit of the Abraxane combination over gemcitabine alone increased over time. At the one-year mark, 35 percent of patients taking Abraxane were alive compared with 22 percent in the gemcitabine-alone arm. Although only a small percentage of patients were followed to the two-year mark, the survival benefit had then doubled (9 percent versus 4 percent). The effect also stretched across various subgroups, even those with poor prognostic factors, such as extent of metastases. The poorer the prognostic factors, the more favorable the addition of Abraxane, Von Hoff said.
Patients who went on to second-line therapy after progressing in the MPACT trial also did better if they had been treated in the Abraxane arm. Although side effects were seen with the combination, including fatigue and peripheral neuropathy, more patients in the Abraxane arm were able to complete their treatment, hinting that it was more tolerable than gemcitabine alone.
Von Hoff predicted that the combination could become a backbone in new regimens for advanced pancreatic cancer.
Philip A. Philip, an oncologist with Karmanos Cancer Institute in Detroit, led the discussion of the study and also proposed Abraxane should be considered with other combinations, as well as in earlier stages of the disease.
"The rational in developing nab-paclitaxel in pancreatic cancer was based on hypothesis largely related to targeting the stroma," Philip said.
Recent studies have shown that one reason pancreatic cancer may be resistant to standard treatment is the stroma, a matrix of cells and molecules that are tightly knit together around the cancer. If Abraxane can weaken the stroma, gemcitabine may have a better chance in getting to the tumor cells, which could explain the synergistic effect researchers are seeing.
"I strongly encourage the investigators to grab this opportunity and go back to the lab to determine the molecular basis of this clinical benefit and its association with any biomarkers, such as SPARC." Research has shown that pancreatic cancers overexpress a protein called SPARC, which may attract Abraxane molecules and subsequently may increase tumor response to the drug. Philips called it an "invaluable opportunity" in developing future trials for this disease.
Celgene, the company that produces Abraxane, is planning to submit the drug to the FDA for approval for this patient population by mid-year. Abraxane is already approved for advanced lung and breast cancers.RELATED POSTS
BY GUEST BLOGGER | NOVEMBER 12, 2012
In July 2007, just two months after my 50th birthday, I was diagnosed with stage 2 stomach cancer--a very aggressive, fast-growing, signet ring cell type. Shocked and frightened, I quickly made appointments with surgeons and oncologists.
As anyone having a cancer diagnosis knows, your initial reaction is "cut it out as soon as possible!" But not everyone is a surgical candidate. I met with the doctors, got second opinions and the consensus was to perform a gastrectomy--hopefully a partial because the cancer appeared to be contained to a localized area. If there was any evidence the cancer had spread, surgery would be followed by chemotherapy and radiation.
Now I had to decide which surgeon was going to perform this very scary surgery. As much as I wanted it "out," I was scared to death about having my stomach removed. What would eating be like? What kind of complications could arise? In the face of a cancer diagnosis though, this really wasn't elective surgery, and I would have to deal with any after effects of the surgery. The more pressing issue was who was going to perform this surgery. Both surgeons were equally skilled and came highly recommended, but the one who could do it sooner, didn't give me the "warm fuzzies." I decided to go with my gut. I'm a person who needs the "warm fuzzies," so my instincts were that I would have a better outcome if I felt cared for emotionally as well as physically.
It seemed like an eternity, but just one month after diagnosis, I had my surgery. The surgeon was able to perform a partial gastrectomy, removing two-thirds of my stomach with clear margins. Thankfully, there was no evidence of spread to any other organs, but 3 of 11 lymph nodes were positive, so chemotherapy and radiation would still be necessary after I recovered.
After a five-day hospital stay, I went home to recover and learned to eat a whole new way. Rather than three large meals, I ate six small meals with no liquids at meal time. At first the meals were very small, maybe just a few bites at a time. The key was to listen to my body--eat when I was hungry and more importantly, stop when I was full.
Chewing well and eating slowly were also key to avoiding any discomfort or nausea. The nutritionist I met with recommended starting out with bland, easy-to-digest foods and then slowly introduced other foods to see what I could tolerate. Trust me, you quickly find out what you can't tolerate. Everyone's different, but for me it was sweets, fried foods and creamy, rich foods. If I had any of those, if I ate too fast, or if I ate too much, I became extremely nauseous. I would begin to sweat, my heart would race, and inevitably, I'd vomit. Not fun, but you learn by trial and error.
One of the biggest challenges though, was getting adequate nutrition during chemotherapy and radiation. The treatments themselves made me very nauseous and took away my appetite. Eating became an even bigger challenge since just about any food I ate would not stay down. It was a very trying time, to say the least. Over the course of six months, I lost 60 pounds, and often felt as though I'd never be "normal" again. But the human body has amazing healing powers. Once my treatments ended in February 2008, I slowly, but surely, got my appetite back, kept foods down, gained my strength back and began to heal.
My husband never left my side and wouldn't let me quit. My teenage sons kept brave faces, kept things light and made me laugh. Friends and family from all over the country took turns coming to stay with us and help out.
It's now been more than five years after my initial diagnosis. I'm cancer-free, feel great, eat normally and am grateful for the experience. Cancer taught me to live in the moment and be grateful for every day I'm given.
For that reason, I committed myself to helping others facing stomach cancer and to help them find information and support that I didn't have when I was facing my surgery and treatment. At the time of my diagnosis, no such organization existed. There was plenty of cancer support, but none specific to stomach cancer.
I am now a resource contact for the Patient Resource Education Program (PREP) of Can't Stomach Cancer and founder of the Maryland chapter. I am honored to be part of such a wonderful organization and able to offer support and hope for survival to other stomach cancer patients and their families.
Gae Rogers is a stage 2 stomach cancer survivor and advocate with Can't Stomach Cancer: The Foundation of Debbie's Dream (CSC), an organization founded by Debbie Zelman, a stage 4 stomach cancer survivor. CSC is a non-profit organization dedicated to raising awareness about stomach cancer, advancing funding for research, and providing education and support internationally to patients, families and caregivers. CSC seeks as its ultimate goal to make the cure for stomach cancer a reality. If you or someone you know is battling stomach cancer, you can find more resources at CantStomachCancer.org or by calling its toll-free hotline at 855-475-1201.RELATED POSTS
BY DEBU TRIPATHY | OCTOBER 29, 2012
The New England Journal of Medicine tends to publish larger and higher impact studies that will affect standards of care, but they also will print eye-opening studies that tell us something unexpected and give us pause for thought.
A very important survey appeared in the Journal recently – it was part of a larger study that explored the attitudes and knowledge of patients with colorectal and lung cancer. This analysis of patients with advanced metastatic cancer who opted for chemotherapy showed that most patients had unrealistic expectations of cure – something that is rare in metastatic cancer. This is in contrast to earlier studies, many of which were done at larger and specialized cancer centers, which showed that most patients understood that cure was not likely.
What does this study say about patients being seen in clinical practice that reflects the average across the United States? At initial glance, it appears that patients are not adequately informed or do not fully understand their accurate prognosis. However, it is difficult to interpret results of questions asked or over the phone and to surrogates who answer in the patient's stead as was the case in this study. This study was not designed to delve into the complexities of patients' levels of hopes and understanding about their disease. Still, there are important lessons for us all in these results.
A higher expectation of cure was seen in patients who were non-white, or had colorectal cancer, and interestingly, who reported better communication with their physician. It means that physicians need to use better educational methods, but still retain their patients' trust and confidence. We live in a time where technology keeps pushing the envelope on outcomes in cancer, but where cure of many common cancers in the metastatic setting is still fleeting. The public needs to make fully informed decisions about their health care – whether it is for metastatic cancer or open heart surgery for coronary artery disease.
In this age of information at one's fingertip, this should be much more achievable, but on the other hand, the savviest of readers needs a guide in the informational jungle. CURE's special edition on metastatic cancer, which will be available in December, aims to educate with compassion, realism and hope – we believe that all of these are mutually compatible.RELATED POSTS
BY KATHY LATOUR | OCTOBER 26, 2012
In the past few years October has become a flash point about the differences that have arisen in the breast cancer advocacy arena.
As I have looked back at my 26 years of survivorship, it makes me sad that we have come to a time when there are those who lament that breast cancer awarness month is here because it points to conflicts among those who have made breast cancer their life's work. They don't like the pink ribbon for one reason or another and are angered that they feel their disease has been usurped by some for marketing purposes.
Maybe it was easier when we were all fighting for recognition of the disease. Then there was a sense that we were all connected by the common scar of breast cancer.
In 1999 I joined thousands of others in Washington,D.C. in October to ask for a national strategy to end the breast cancer epidemic. It was the first time I had ever joined women from around the country to march for something that I felt so strongly about. We marched past the White House holding signs, some of which asked for research dollars, others telling personal stories of mothers or daughters lost to this disease. It was a first for the young movement.
One young husband carried a sign with a photo of his wife that simply said, "Too Young To Die."
We were Black, White, Brown, Asian, young, middle-aged, and elderly. It was clear that we represented every socioeconomic group and were decidedly bipartisan.
We chanted together, cried together and got angry together. We were bound by a common experience. We were bound by a common scar, which seemed to thread endlessly through the crowd, linking us together.
I remember thinking then that in only a few days October would end and breast cancer would no longer be daily news. No longer would the media surround the cause and publicize our stories. The spotlight would turn to other events, but the disease would go on, marching across the country, extending the pain that linked us.
Today, women still die of breast cancer in the tens of thousands. But the small percentage point drops have been touted as significant. Yes, we have made small headway. But not nearly as much as we should. The difference is that while more women are being diagnosed with breast cancer, more women are surviving.
I guess that makes the 39,920 women who are expected to die from breast cancer in 2012 less visible except to the ones who love them.
I wish we could turn our focus back toward them during October.RELATED POSTS
BY KATHY LATOUR | OCTOBER 22, 2012
For two days last week I was surrounded by attendees at the FORCE, Facing Our Risk of Cancer Empowered, conference in Orlando. The topic of discussion was hereditary cancer, primarily those living with the BRCA 1 and 2 mutations that cause breast and ovarian cancer.
This year there are around 600 gathered from around the world (12 countries) to explore topics related to living with the hereditary cancer experience: risk, surgical options, surveillance, advocacy, and talking with family. It's only at this conference that you hear the term "previvor" for those women and men who carry the BRCA mutations but have not had cancer – primarily because of the preemptive strikes of hysterectomy and bilateral mastectomy.
Family dynamics were everywhere at FORCE because someone in the family had to be the first one to learn of the mutation, and then he or she had to decide what to do with the information. While that may seem to be a fairly clear issue to most readers, it's one that can be extremely complicated by family dynamics, history, insurance, and fear.
In some instances the mutations have drawn families together to learn more for themselves and their children. In other instances, the mutation becomes the family secret – a secret that can kill. More than once I heard someone ask what to do when a family member refused to admit to themselves or have a child tested when he or she was positive for a mutation.
At the networking lunch I sat with two different groups. The first table was parents with BRCA mutations who were discussing how they told their children – or didn't. One mother, who carried both BRCA 1 and 2, broke my heart. She had known since her diagnosis of breast cancer at age 34 that she carried the mutations. At the time of her breast cancer, her daughters were 1 and 3. They are now 17 and 20 and she still has not told them. She sat and listened to the other mothers talk about the reactions from their children, and it was clear to see that she was terrified how her daughters would react to the news that they had a 50 percent chance of carrying the mutation, and that would mean choosing to lose their breasts and having a hysterectomy to ensure they would not get cancer.
Imagine trying to tell your daughters this news when they are dating or falling in love and then they have to pass the news along to their potential husband. She had come to the FORCE conference to get help and was going to attend a workshop on telling children that afternoon.
Janet, a breast cancer nurse at the time of her own breast cancer diagnosis, was tested for the mutation because of her relatively young age at diagnosis. When the results came back positive, her mother immediately said it was her father who was to blame since there was cancer in his family not hers. Janet was shocked, as was her younger sister, and both were angry with their father who knew there was "woman" cancer is the family but never thought it was anything to talk about. Her sister has still not forgiven him.
Janet has told her daughter and son they will need to be tested at age 25, the age recommended. Before that she wants to be sure they have life insurance and a good job. Another mother commented on the pressure it puts on their children to get their lives started early so they can get life insurance, which, unlike health insurance, can be denied based on hereditary cancer risk.
From that table I moved to another that was supposed to be for men with the mutation. I took the only open seat at the table and found myself surrounded by a whole family – four siblings and their spouses. The siblings – two brothers and two sisters – were all positive for the BRCA 1 mutation that was discovered when one sister decided to be tested. Their mother had died of ovarian cancer 16 years ago and one of her sisters had died of breast cancer. Her husband was completely in favor of the testing after watching what his mother in law had gone through. The other siblings were tested after their sister was found to be positive. One sister had already had bilateral mastectomy and hysterectomy, the other sister was planning her surgery.
It was time to move to the next breakout session and the family was dividing up the breakouts to take notes as they moved away from the table. Their choices: reconstruction options, screening after mastectomy, sexuality and body image, communicating with family members, understanding risk, or ovarian cancer survivor networking.RELATED POSTS
BY JON GARINN | SEPTEMBER 24, 2012
It's been nearly 30 years since my dad died from lung cancer. I never realized how memories of his unwillingness to stop smoking would still have an impact on me today.
Yet while our editorial team was discussing a lung cancer feature we're planning for next summer, Kathy LaTour's suggestion that we include a sidebar with tips on how to stop smoking drew from me an unanticipated response: I was incredulous.
How, I wondered, could smoking cessation tips have any impact on people determined to continue smoking even after receiving a lung cancer diagnosis? If they are addicted and determined to continue smoking, then no amount of advice we could provide would make any difference, I opined. It would just be a waste of space.
After much debate about the merits of including such tips, it suddenly occurred to me that my resistance to the idea was based on my caregiving experience from so long ago. I hated the fact that Dad kept smoking throughout his treatment and until his death. He was fiercely determined to beat his cancer, but he was also stubbornly opposed to breaking the habit. His brother continued to smoke through his tracheotomy tube, despite the ravages of throat cancer. My mom still smokes, and grows belligerent if anyone dares suggest she give up one of the only things that she enjoys.
Fortunately, my colleagues helped be recognized my transference. That was then; this is now. There are a lot more smoking cessation tools and assistance programs than there were 30 years ago. And it's unfair to our readers to assume they'll be as intransigent as my father or my uncle or my mother.
Without question, more can be done to help people stop smoking (the challenge is even greater among certain minority populations, as we reported on several years ago). And practical advice always trumps platitudes about willpower. Our commitment is to continue providing the very best information backed by science, even when that commitment is driven by a three-decade-old wish that didn't come true.
November is Lung Cancer Awareness month. Consider some of the facts about the disease: